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The objective of this study is to determine whether VR can ameliorate symptoms for palliative care patients within a hospice setting. We also aim to verify the efficacy with a larger sample size than previously shown, as well as extend the population to include non-cancer patients receiving Hospice care. We will further attempt to delineate whether there is a sustainability of symptomatic improvement one week after VR experiences.
Potential candidates will be provided with our assent and consent information form and the study will be explained to them in detail prior to gaining consent. As per standard practice at The Hospice of Windsor & Essex County, palliative care ESAS symptoms will be measured at baseline during the week prior to the VR experience. The mean of these pre-VR scores will be calculated as a baseline, optimally 3 separate ESAS scores in the preceding week. ESAS symptoms and expectations/satisfaction will then be measured immediately before and after the VR experience. An average set of ESAS scores will then be calculated in the same manner for one week post VR as per baseline pre-VR scores above.
We expect to find a decrease in Palliative Care symptoms after the intervention of a VR experience.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| VR experience | Experimental | Participants will be given a list of VR applications to choose from. They will then be given instructions by a research assistant (approximately 10 minutes) on how to use the selected application they have chosen, as well as time for any questions they may have before starting their VR experience. They will then have an approximately 30-minute session of that VR experience. They may or may not be accompanied by a family member or significant other and will also have a research assistant available to aid them in any difficulties experienced during the VR experience. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual Reality | Device | The intervention is a Virtual Reality experience within a selected application using an Oculus Quest 2 ©, as previously in the relevant intervention arm. |
| Measure | Description | Time Frame |
|---|---|---|
| VR experience effect on pain, shortness of breath, depression, anxiety, and well-being scores (0 - 10) | The primary outcome of this study will be a significant difference in change of ESAS score for 5 key symptoms (pain, shortness of breath, depression, anxiety, and well-being) immediately before and after a VR experience. | ESAS scores measured immediately before VR experience will be compared to ESAS scores measured immediately after VR experience |
| Measure | Description | Time Frame |
|---|---|---|
| VR experience longitudinal effect (one week later) on baseline pain, shortness of breath, depression, anxiety, and well-being scores (0 - 10) | The first secondary outcome of this study will be a significant difference between the mean of the 1-week pre-VR and the mean of the 1-week post-VR ESAS scores for 5 key symptoms (pain, shortness of breath, depression, anxiety, and well-being). For more objective evaluation of pain and distress we will also be measuring vitals immediately before and immediately after each VR experience. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Patricia Valcke, MD | Contact | (519) 974-7100 | pvalcke@thehospice.ca | |
| Natan Veinberg, MD | Contact | (519)991-7050 | nveinberg2021@meds.uwo.ca |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Hospice of Windsor and Essex County | Recruiting | Windsor | Ontario | N8T1B5 | Canada |
Currently, there is no plan to make individual participant data (IPD) available to other researchers.
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| ID | Term |
|---|---|
| D009369 | Neoplasms |
| D003863 | Depression |
| D001008 | Anxiety Disorders |
| D010146 | Pain |
| D004417 | Dyspnea |
| ID | Term |
|---|---|
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |
| D001523 | Mental Disorders |
| D009461 | Neurologic Manifestations |
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ESAS scores for 5 key symptoms (pain, shortness of breath, depression, anxiety, and well-being) and qualitative question(s) will be asked verbally by one of the investigators and recorded on an ipad directly into the Qualtrics form, before and after the VR session. Vital signs (blood pressure, heart rate, respiratory rate) will also be measured before and after the VR session. Participants will be given a list of VR applications to choose from. They will then be given instructions by a research assistant (approximately 10 minutes) on how to use the selected application using Oculus Quest 2 they have chosen, as well as time for any questions they may have before starting their VR experience. They will then have an approximately 30-minute session of that VR experience. They may or may not be accompanied by a family member or significant other and will also have a research assistant available to aid them in any difficulties experienced during the VR experience.
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| Baseline average ESAS scores measured one week prior to the VR experience will be compared to the average of ESAS scores one week following the VR experience. |
| VR experience effect on Mean Arterial Pressure (MAP) (part of vital signs) as indicator for Pain and/or Distress | For more objective evaluation of pain and distress, the investigators will be measuring blood pressure to compare the Mean Arterial Pressure (MAP; mmHg) immediately before and immediately after each VR experience. | MAP measured immediately before and immediately after each VR experience. |
| VR experience effect on Heart Rate (HR) (part of vital signs) as indicator for Pain and/or Distress | For more objective evaluation of pain and distress, the investigators will be measuring Heart Rate (HR; beats per minute [bpm]) immediately before and immediately after each VR experience. | HR measured immediately before and immediately after each VR experience. |
| VR experience effect on Respiratory Rate (RR) (part of vital signs) as indicator for Pain and/or Distress | For more objective evaluation of pain and distress, the investigators will be measuring Respiratory Rate (RR; breaths per minute [brpm]) immediately before and immediately after each VR experience. | RR measured immediately before and immediately after each VR experience. |
| D012816 |
| Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D012818 | Signs and Symptoms, Respiratory |